Results For Early Diagnosis Research Articles

Long-term survival trends for primary liver and pancreatic cancers in the Nordic countries

Liver cancer (LC) and pancreatic cancer (PC) are often diagnosed at an advanced stage resulting in high mortality. High-quality survival data are rarely available for trend analyses over a long period. The Danish, Finnish, Norwegian, and Swedish cancer data were accessed at the NORDCAN database. We analysed relative 1- and 5-year survival trends in LC and PC between years 1970 and2019. Relative 1-year survival in LC for Nordic men and women was about 10% in the period between 1970 and 1974, and it increased moderately by year 2000 and steeply thereafter, eventually reaching 40-50%. The patterns in 5-year survival were similar, but after the year 2000, survival in Norway and Sweden increased steeply to 23%, whereas survival in Denmark and Finland lagged behind, reaching 10% to 15%. The patterns for PC also showed rapid improvement after the year 2000, with 1-year survival reaching 30% to 40% and 5-year survival reaching 10% for Finland and 15% for Norway and Sweden. Survival was best for patients diagnosed before age 50 years, and it was worst for older patients. For both cancers the difference between 1- and 5-year survival increased with time. Survival in LC and PC improved first modestly and then steeply over the 50-year period covered. The increase in 5-year survival was less than that of 1-year survival. The survival gains were most likely the result of earlier diagnosis, improved treatment, and better organised supportive care. The challenges are to keep up these positive trends, to extend survival benefits past Year 1, and to obtain similar results in elderly patients. Primary prevention through avoidance of risk factors would reduce case numbers. Liver and pancreatic cancers are among the most lethal of all cancers. In 50 years, survival in these cancers has slowly improved, and in the past 20 years, the development has been increasingly favourable. Widespread adoption of healthy lifestyles will be key to reducing the risk of these cancers.

What happens when the newborn hearing screening program is integrated with congenital Cytomegalovirus infection screening? Preliminary results in a tertiary hospital

Objective Early diagnosis of congenital Cytomegalovirus (cCMV) infection related hearing loss has increased since the spread of newborn hearing screening (NHS) programs worldwide. However, since most newborns affected are asymptomatic at birth but may develop hearing loss later, some of them may elude the NHS. The aim of this study was to compare the results in two cohorts of children, in one of which all newborns who failed the NHS were tested for cCMV. Methods We retrospectively compared the results of early diagnosis of cCMV-related hearing loss between two groups of patients at a high-volume centre. Group 1 included the first 3 years of activity without a targeted cCMV screening and was composed of children born between 2012 and 2014. Group 2 included neonates born between 2015 and 2017: in this group, those who failed the NHS underwent urine CMV analysis within 14 days. Results There were 17,229 live births during the study period, 20 were diagnosed with cCMV infection, with a global prevalence of 1.1:1000. 72 neonates (0.42%) with hearing loss were identified, 7% of which were diagnosed with cCMV infection, 3/34 (8.8%) in group 1 and 2/38 (5.3%) in group 2 (p = .66). One newborn in group 2 was identified through the protocol. The percentage of patients affected by cCMV-related hearing loss diagnosed during the NHS showed non-significant differences in the two groups. Conclusion Our results suggest that the suspicion index of cCMV infection in a tertiary hospital is currently high and neonatologists are able to identify most symptomatic cases which have higher risk of developing hearing loss. Coupling the cCMV screening and the NHS program is worthwhile as it allows early recognition of asymptomatic cases with hearing loss and subsequent immediate administration of antiviral therapy.

Application of Sensor Networks for Measuring Insulin Levels

All WBANs are low-speed networks consisting of intelligent sensors and low-power actuators that can be placed on the body or implanted in humans. With the help of these networks, timely on-line data on unusual conditions of the human body can be provided, which leads to significant improvements in the quality of life. The implementation of these networks will save lives, reduce healthcare costs, and eliminate the need for costly monitoring of patients in the hospital. The paper analyzes the possibilities of the Internet of Things technology, communication standards, cloud technologies, and hardware components for developing a system for monitoring insulin levels in diabetic patients. A model and algorithm for design, construction, and management of a sensor network for monitoring insulin levels with simulation software based on the Internet of Things technology proposed. A system for monitoring insulin levels through a cloud structure has designed, which sends a message to a specialized health centre or the attending physician about the condition of diabetic patients. Simulation studies performed, and the operability of the system examined. The results give reason to believe that the considered model and the simulation project of a system for monitoring insulin levels in patients with diabetes is successful, gives realistic and reliable results for early diagnosis and prevention of various complications and can be implemented in practice.

Automated Computer Aided System for Early Diagnosis of Alzheimers Disease by Regional Atrophy Analysis in Functional Magnetic Resonance Imaging

A growing body of researchers suggest that a preanalytic step of neurogenetic Alzheimer's disease (AD) characterised by precise neuropsychological and brain changes, may exist several years earlier to the overt manifestation of clinical symptoms. FMRI is a one of the effective neuroimage which helps to predict the brain change in AD. This paper introduces the automatic AD disease detection system (ACAS) for early diagnosis of AD using FMRI. The system consists of four stages: preprocessing, feature extraction, segmentation and regional atrophy analyses. The preprocessing removes the noise in the FMRI image; multiscale analysis (MSA) is used to analyse FMRI to obtain its fractals at six different scales, which produce different feature vectors to discriminate between healthy and pathological patients; self-organising map (SOM) is applied to divide the affected region which is one of the effective unsupervised network that utilises the obtained feature vectors for competitive learning; the regional atrophy analyses are used to differentiate AD from other neurodegenerative diseases. Compared to MRI, the proposed system gives more satisfactory results for early diagnosis and differentiation of AD from other neurodegenerative diseases.

Incidence of colorectal cancer in young patients.

Sporadic colorectal cancer (CRC) is traditionally diagnosed after de sixth decade of life, although a small percentage of cases are diagnosed in patients under 40 years of age, and incidence is increasing. There exists a great volume of controversy regarding clinical outcome of young patients diagnosed with colorectal cancer (CRC) when compared to elder counterparts. Our aims were to evaluate the rate of CRC in young patients, to review the pertaining literature and to discuss outcomes and clinical prognosis. A retrospective review involving patients with CRC was undertaken, focusing on age at diagnosis. The information extracted from this literature review showed a trend towards a decreased incidence in older people with an opposite effect among adolescents and young adults. Moreover, biological aggressiveness in young adults diagnosed with CRC has not been fully recognized, although it is usually diagnosed later and in association with adverse histological features. Besides that, these features don't affect outcome. These apparent increase in CRC incidence among young patients during the last decades raises the need for a greater suspicious when evaluating common symptoms in this group. Thus, educational programs should widespread information for both population and physicians to improve prevention and early diagnosis results.

Dual duodenal obstruction: an abdominal camouflage

Congenital Double Duodenal Obstruction (DDO) is a clinical entity with a combination of annular pancreas and distal duodenal obstruction (either due to duodenal membrane or atresia). Hereby reporting a case of double duodenal obstruction in a 7 years boy, confirmed by barium meal, CECT abdomen and MRI abdomen. Bile-stained vomitus in neonates is the typical presentation of atresia or severe stenosis. Minimal duodenal obstruction in mild stenosis or membrane may present with clinical features, which include polyhydraminos, low birth weight, feeding intolerance, vomiting, failure to thrive, epigastric distension and visible gastric peristalsis. Duodeno-duodenostomy is the surgery of choice in cases of duodenal obstruction due to atresia, diaphragm and annular pancreas. The morbidity and mortality rate of patients with congenital duodenal obstruction is very high. Effective measures such as early diagnosis and intervention, proper preoperative preparation, nutritional support are urgently needed to improve the outcome. Low birth weight and prematurity significantly affect the outcome, associated anomalies account for most of the morbidity and mortality and early diagnosis result in better outcome.

A statistical index for early diagnosis of ventricular arrhythmia from the trend analysis of ECG phase-portraits

In this paper, we propose a novel statistical index for the early diagnosis of ventricular arrhythmia (VA) using the time delay phase-space reconstruction (PSR) technique, from the electrocardiogram (ECG) signal. Patients with two classes of fatal VA—with preceding ventricular premature beats (VPBs) and with no VPBs—have been analysed using extensive simulations. Three subclasses of VA with VPBs viz. ventricular tachycardia (VT), ventricular fibrillation (VF) and VT followed by VF are analyzed using the proposed technique. Measures of descriptive statistics like mean (µ), standard deviation (σ), coefficient of variation (CV = σ/µ), skewness (γ) and kurtosis (β) in phase-space diagrams are studied for a sliding window of 10 beats of the ECG signal using the box-counting technique. Subsequently, a hybrid prediction index which is composed of a weighted sum of CV and kurtosis has been proposed for predicting the impending arrhythmia before its actual occurrence. The early diagnosis involves crossing the upper bound of a hybrid index which is capable of predicting an impending arrhythmia 356 ECG beats, on average (with 192 beats standard deviation) before its onset when tested with 32 VA patients (both with and without VPBs). The early diagnosis result is also verified using a leave one out cross-validation (LOOCV) scheme with 96.88% sensitivity, 100% specificity and 98.44% accuracy.

Commitment to reducing disability: the Brazilian experience

In the last 20 years, Brazil has made great efforts to introduce the assessment and prevention of physical disabilities (POD) along with the wider decentralisation of leprosy control activities to primary health care level. The advances achieved on this front are due in considerable part to the support of the ILEP organisations that have worked in the country over this period. The Lauro de Souza Lima Reference Centre has been doing regular training in POD for 30 years as physiotherapists and occupational therapists increasingly became part of local teams of health professionals. In 1998, the National Programme report highlighted the significant impact that the MDT era had not only curing thousands of patients, but also prevented the deformities caused by the disease. This was a result of early diagnosis and the reduction of Grade 2 disability from 15% in 1987 to 7% in 1998. The current criteria to assess disability grade are shown in Table 1. Note that in Brazil Grade 1 includes reduced sensation in the eyes, which differs from WHO criteria. The percentage of new cases assessed (Figure 1) since the inclusion of the disability grade indicator (0, 1 and 2) among newly diagnosed cases.

Thoracic neuroblastic tumors in childhood

Thoracic neuroblastic tumors (NBTs) are reported to have better prognosis. We aimed to review clinical characteristics, treatment results, and outcome of our patients with thoracic NBT. Files of 87 children treated at our hospital between 1973 and 2007 with the diagnoses of thoracic NBT were reviewed for clinical and pathological characteristics. Treatment results and outcomes of these cases were examined. All but one tumors were located in posterior mediastinum, one in the posterior chest wall. Median age of all was 2.1 years (range, 0.03-14; F/M: 1.42). Fifteen cases had ganglioneuromas (GN), 26 ganglioneuroblastomas (GNBL), and 46 neuroblastomas (NBLs). Stages were: I, 20.5%; II, 22.1%; III, 38.2%; IV, 14.7%; IVS, 4.5%. Stages III and IV were more common in cases over 1 year of age. In 20 patients diagnoses were incidental. Twenty-two of 87 (25.3%) had symptomatic spinal cord compression and 15 (17.3%) had Horner syndrome. Ten-year overall and event-free survival rates were 71.2% and 67.4%, respectively. Survival rates did not differ depending on the age being younger or older than 1 year. Ten-year survival rates were 88.8% in stages I, II, IVS; 65.3% in stage III and 27.8% in stage IV (P = 0.0002). Thoracic NBLs had a favorable prognosis. This might be a result of earlier diagnosis and some distinct biological characteristics. Favorable prognosis would suggest less aggressive treatment for such patients. Further studies on the biological characteristics of NBLs in the thoracic site and their association with outcome should be done.

Declining prevalence of diabetes mellitus in hereditary haemochromatosis—The result of earlier diagnosis

Aims The aims of this study were to describe the prevalence and clinical features of diabetes in hereditary haemochromatosis (HH), with particular emphasis to how this has changed since the introduction of genetic testing in 1996. Subjects and methods Two hundred and thirty-seven patients were diagnosed with HH (based on elevated iron indices and liver biopsy or genetic testing) by a single physician, and all biochemical and clinical data recorded from diagnosis to the end of the study. Results The prevalence of diabetes (21.9%) was lower than most previously published studies. There was a significantly greater prevalence of diabetes and cirrhosis in those diagnosed before the introduction of genetic testing, p < 0.001. The type of genetic mutation for HH, degree of ferritin elevation at diagnosis, or the presence of cirrhosis was not predictive for the development of diabetes. Iron depletion did not result in an improvement in glycaemic control or reduction in insulin requirements in the majority of patients. Conclusions This is one of the largest published series of diabetes in HH. Because the occurrence of diabetes in patients with HH reduces life expectancy, our finding of a lower prevalence of diabetes is expected to translate into a greater survival rate in these patients.

Prevention of blindness in leprosy and the role of the Vision 2020 Programme

Leprosy control programmes are highly successful. As a result, leprosy control will be more and more integrated into the general health services. The existing vertical, specialized control programmes will be dismantled. Eye complications in leprosy have decreased. This is a result of earlier diagnosis and highly effective multidrug treatment (MDT) of leprosy, combined with timely treatment of secondary nerve damage by steroids. Most ocular morbidity is now found among elderly and disabled leprosy patients who were diagnosed before effective MDT treatment became available. Many of these patients live in leprosy settlements. Age-related cataract has become the leading cause of blindness in leprosy. The second cause of blindness is corneal opacification, mainly as a result of neglected exposure keratitis and corneal anaesthesia. The miotic pupils in late multibacillary leprosy, in combination with small central lens opacities, may also lead to blindness. The Vision 2020 Initiative prioritises cataract surgery. Leprosy patients should be actively included. Disabled leprosy patients can also benefit from screening programmes for refractive errors and the provision of spectacles and low vision aids. Determining the most feasible surgical methods for lagophthalmos surgery remains a challenge. For all health and eye care staff, training in leprosy and its eye complications is needed, as well as a change in attitude towards leprosy patients. Staff must be prepared to welcome them in the general health services.

Decreasing mortality rates for prostate cancer: possible role of hormonal therapy?

Within the last decade prostate cancer mortality rates have started to decrease in some countries. Although it is tempting to assume that these trends are a result of earlier diagnosis and aggressive therapeutic intervention, as a consequence of prostate-specific antigen screening, definitive results from randomized trials of screening will not be available for several years. Moreover, there is mounting evidence that the effects of screening cannot be entirely responsible for this reduction in mortality rates. This review explores the possibility that other factors, particularly the increased uptake of early hormonal therapy, are contributing to the observed changes in mortality.

Update of a prospective study of mortality and cancer incidence in the Australian petroleum industry

Aims: To update the analysis of the cohort mortality and cancer incidence study of employees in the Australian petroleum industry. Methods: Employees from 1981 to 1996 were traced through the...

CORRESPONDENCE

The debate about the benefits of breast screening in the population continues ith the publication of the Cochrane review (Olsen and Gotzsche, 2001). The issues raised by the authors have been challenged by Stephen Duffy in his editorial (vol 63(12), 2002, p. 708). Each issue has been debated and rejected based on convincing argument. There can be little doubt that breast screening improves mortality in breast cancer. This is believed to be a result of earlier diagnosis of invasive and pre-invasive lesions. In combination with better treatment strategies, this has led to a substantial reduction in mortality in women with breast cancer (Peto et al, 2000).

Doença cardíaca isquêmica: a prevenção inicia durante a infância

To review the main risk factors for ischemic heart disease and preventive strategies during childhood. Medline review between 1985 and 2001, and key references from the studies evaluated. Preventive interventions that may start in childhood are described for risk factors such as hyperlipidemias, obesity, smoking and systemic hypertension. Results of early diagnosis and efficiency of interventions are discussed. Recent studies have shown that life styles potentially associated with atherosclerosis begin during childhood. Thus, early intervention regarding these life styles could have impact on adult behavior, reducing the prevalence of this pathologic condition.

Using recombinant human TSH in the management of well-differentiated thyroid cancer: current strategies and future directions.

Mortality rates from thyroid cancer have fallen significantly in recent decades, almost certainly as the result of earlier diagnosis and improved treatment of differentiated (papillary and follicular) thyroid cancer. Enhanced survival is likely a result of early diagnosis and therapy applied at a disease stage when treatment is most effective. In the United States and Europe, most patients at high risk for relapse and death from thyroid cancer are treated with total or near-total thyroidectomy and receive radioiodine ablation of residual normal or malignant thyroid tissue, followed by treatment with thyroid hormone, a strategy that cures more than 80% of patients. Still, some die of the disease and nearly 15% have local recurrences, while another 5% to 10% develop distant metastases. Over 50% of recurrences appear in the first five years, but distant metastases may surface years, and sometimes decades, after initial therapy. Much has been learned about risk stratification to predict recurrence and death from thyroid cancer but individual patients continue to have adverse outcomes not always foreseen by a low tumor stage. Follow-up must accordingly be meticulous and prolonged. The National Cancer Center Network (NCCN) has recently established consensus practice guidelines that give explicit advice about the diagnosis and management of benign and malignant thyroid tumors, including paradigms for long-term follow-up and the treatment of recurrent disease. The guidelines confirm that diagnostic scanning with 131I and measurement of serum thyroglobulin (Tg) levels are the mainstay of follow-up, offering the opportunity to detect recurrent or persistent cancer at very early stages. These guidelines advocate TSH-stimulated serum Tg measurements, done either during thyroid hormone withdrawal or stimulation with recombinant human TSH (rhTSH, Thyrogen), that often identify the presence of cancer well before diagnostic whole-body scanning or other imaging studies can spot the tumor, which offers the opportunity to treat recurrent disease at an early stage. The use of rhTSH adds a new dimension to long-term follow-up that avoids putting patients through the symptoms of hypothyroidism, and offers the opportunity to follow some patients with rhTSH-stimulated serum Tg levels without performing 131I whole-body scans. A multicenter international study has shown that serum Tg measurements alone are not as sensitive in the identification of patients with persistent or recurrent tumor as are rhTSH-stimulated serum Tg determinations. Although not yet approved for preparation of patients for 131I therapy, rhTSH has been used successfully in a compassionate use program for this purpose in a relatively large number of patients. Formal clinical investigations now planned to provide guidelines for the use of rhTSH for therapeutic 131I portend a new set of effective therapeutic paradigms for the management of differentiated thyroid cancer.

Results of early diagnosis and surgical treatment for bronchogenic squamous cell carcinoma : Saito Y, Sato M, Sagawa M, Kamma K, Takahashi S, Usuda K et al. Department of Surgery, Institute for Development, Aging and Cancer, Tohoku University, Sendai 980, Japan

Results of early diagnosis and surgical treatment for bronchogenic squamous cell carcinoma : Saito Y, Sato M, Sagawa M, Kamma K, Takahashi S, Usuda K et al. Department of Surgery, Institute for Development, Aging and Cancer, Tohoku University, Sendai 980, Japan

Prediction of the gastric cancer mortality in 2000 in Japan.

Gastric cancer mortality in Japan in the year 2000 has been predicted from sex‐ and age‐specific incidences and mortality trends and patient cure rates. The difference between the log‐linear decrease in incidence and the log‐quadratic decrease in mortality was considered to be the result of early diagnosis and treatment. Even on the assumption that 90% of patients could be cured in 2000, the number of deaths was estimated to be about 10,000. The decreasing incidence of cases brought about by birth cohort effects may contribute towards lowering the number of patients. The importance of health education in lowering the incidence of gastric cancer, by teaching people to keep up a sound life style, is discussed.

Present status of thermography, ultrasound and mammography in breast cancer detection.

Various biophysical methods have been utilized in the diagnosis of breast cancer. To date the best results have been obtained with x-ray mammography. Ultrasound and thermography have great appeal as non-destructive techniques but, in the present state of development, are of limited use. The spatial resolution presently obtainable in ultrasonograms is inadequate for the detection of subclinical cancer and thermography is also of questionable reliability. While an overall true positive rate of 70% to 75% may be anticipated with thermography, the bulk of false negatives would seem to occur in those tumors most amenable to therapy, i.e., subclinical cancers. The "false positive" rate of thermography is also excessive, but would be acceptable for establishing a high risk group if true positive rates could be improved. At present thermography finds its greatest use as an adjunct to mammography and physical examination; it should not be used as the sole modality in a screening program. The efficacy of mammography can be readily demonstrated but the propriety of its use as a screening device has been questioned. This is primarily related to the possible carcinogenic effect of radiation at diagnostic levels. Although the carcinogenic effect is unproven, the dose in radiologic procedures should be kept to a minimum consistent with adequate images. The present state of the art would indicate that the risk, if any, is minimal as contrasted with the natural incidence of breast cancer and the results of early diagnosis and treatment.

Congenital dislocation of the hip

The results of early diagnosis and treatment of congenital dislocation of the hip (CDH) in Malmo were investigated. In 60,000 live births, 4 cases were missed in the newborn. Clinical and radiological re-examination including anthropometrical measurements at the average age of 10.3 proved that all treated hips were normal.